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[Transorbital penetrating brain injury]
S Kasamo1, T Asakura, K Kusumoto
1Department of Neurosurgery, Faculty of Medicine, University of Kagoshima, Japan.
No Shinkei Geka. Neurological Surgery
|April 1, 1992
Summary
Transorbital penetrating brain injuries, though rare, can cause severe intracranial complications. Prompt diagnosis and treatment, like the "pull and see" approach, lead to good outcomes in most cases.
Area of Science:
- Neurosurgery
- Trauma Surgery
- Emergency Medicine
Background:
- Transorbital penetrating brain injury (TPI) is an uncommon but severe form of head trauma.
- Understanding the mechanisms and complications is crucial for effective management.
Observation:
- Seven cases of TPI were analyzed, with injuries caused by common objects like chopsticks, pencils, and metal fragments.
- Intracranial complications included hematomas, contusions, hemorrhages, pneumocephalus, brain stem injury, and carotid cavernous sinus fistula.
- No infectious complications were observed.
Findings:
- Object trajectory dictates the site and severity of injury; superior orbital fissure/optic canal penetration leads to critical complications.
- Injuries across the thin orbital roof commonly affect the frontal lobe, causing intracerebral hematoma.
- The "pull and see" treatment strategy, combined with advanced imaging (CT, MRI), resulted in good recovery for most patients.
Implications:
- Early and accurate diagnosis using CT and MRI is vital for identifying foreign bodies and intracranial damage.
- Timely surgical intervention, guided by imaging, can significantly improve patient prognosis.
- This study highlights the importance of a systematic approach to managing transorbital penetrating brain injuries.